Tuesday, October 03, 2006

The case for "natural" IVF

The standard IVF treatment cycle involves the administration of hormones to stimulate the ripening of multiple follicles so that a number of eggs can be harvested and fertilized, hopefully yielding several healthy embryos for implantation. However, the hormones can cause complications in some cases, and they are quite expensive. A few fertility centers are practicing what they call "natural" IVF. There are no hormone injections, just close monitoring of the monthly cycle and development of the (normally one) egg. Just as the egg is ripening it is harvested, fertlized and implanted as in standard IVF.

The advantage, say the fertility centers practicing this approach, is no risk from the use of ovarian stimulation hormones, normally healthier embryos since a high percentage of eggs produced as the result of hormone injections are abnormal, a healthier and more natural uterine lining leading to higher implantation success rates, and the cost is one-third that of standard IVF.

The main disadvantage is lower success rate per cycle, typically 10% in the best cases, compared to 25% to 30% with standard IVF.

Obviously the costs savings is offset by the lower success rate, since it might take three cycles at one-third the cost to reach the same success rate as standard IVF. That is not on a per case basis, of course, but an overall average. The centers say that the lower success rate is largely due to the implantation of a single embryo instead of two as in standard IVF. However, some studies have shown that single embryo implantation are nearly as successful as multiple embryo implantation in standard IVF and some doctors are advocating it to avoid the risk of multiple births. So the much lower success rate of "natural" IVF seems a bit of a mystery.


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